Healthcare Provider Details

I. General information

NPI: 1659186039
Provider Name (Legal Business Name): ANGEL'S SPEECH THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N BOYD ST
FLORENCE SC
29506-6114
US

IV. Provider business mailing address

507 N BOYD ST
FLORENCE SC
29506-6114
US

V. Phone/Fax

Practice location:
  • Phone: 843-687-8330
  • Fax:
Mailing address:
  • Phone: 843-687-8330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: QUANESHA LINETTE BURGESS
Title or Position: OWNER
Credential: MS, CCC-SLP
Phone: 843-687-8330